de Voer Richarda M, Hahn Marc-Manuel, Mensenkamp Arjen R, Hoischen Alexander, Gilissen Christian, Henkes Arjen, Spruijt Liesbeth, van Zelst-Stams Wendy A, Kets C Marleen, Verwiel Eugene T, Nagtegaal Iris D, Schackert Hans K, van Kessel Ad Geurts, Hoogerbrugge Nicoline, Ligtenberg Marjolijn J L, Kuiper Roland P
Department of Human Genetics, Radboud university medical center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
Department of Pathology, Radboud university medical center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
Sci Rep. 2015 Sep 11;5:14060. doi: 10.1038/srep14060.
Bloom syndrome is an autosomal recessive disorder characterized by chromosomal instability and increased cancer risk, caused by biallelic mutations in the RECQL-helicase gene BLM. Previous studies have led to conflicting conclusions as to whether carriers of heterozygous BLM mutations have an increased risk to develop colorectal cancer (CRC). We recently identified two carriers of a pathogenic BLM mutation in a cohort of 55 early-onset CRC patients (≤45 years of age), suggesting an overrepresentation compared to the normal population. Here, we performed targeted sequencing using molecular inversion probes to screen an additional cohort of 185 CRC patients (≤50 years of age) and 532 population-matched controls for deleterious BLM mutations. In total, we identified three additional CRC patients (1.6%) and one control individual (0.2%) that carried a known pathogenic BLM mutation, suggesting that these mutations are enriched in early-onset CRC patients (P = 0.05516). A comparison with local and publically available databases from individuals without suspicion for hereditary cancer confirmed this enrichment (P = 0.003534). Analysis of family members of the five BLM mutation carriers with CRC suggests an incomplete penetrance for CRC development. Therefore, these data indicate that carriers of deleterious BLM mutations are at increased risk to develop CRC, albeit with a moderate-to-low penetrance.
布卢姆综合征是一种常染色体隐性疾病,其特征为染色体不稳定和癌症风险增加,由RECQL解旋酶基因BLM的双等位基因突变引起。先前的研究对于杂合BLM突变携带者患结直肠癌(CRC)的风险是否增加得出了相互矛盾的结论。我们最近在一个由55例早发性CRC患者(≤45岁)组成的队列中鉴定出两名致病性BLM突变携带者,这表明与正常人群相比,该突变携带者的比例过高。在此,我们使用分子倒置探针进行靶向测序,以筛查另外一组185例CRC患者(≤50岁)和532名群体匹配对照中是否存在有害的BLM突变。我们总共又鉴定出三名CRC患者(1.6%)和一名对照个体(0.2%)携带已知的致病性BLM突变,这表明这些突变在早发性CRC患者中富集(P = 0.05516)。与来自无遗传性癌症嫌疑个体的本地和公开可用数据库进行比较证实了这种富集现象(P = 0.003534)。对五名携带BLM突变的CRC患者家庭成员的分析表明,CRC发生的外显率不完全。因此,这些数据表明,有害BLM突变携带者患CRC的风险增加,尽管外显率为中度至低度。